When medicines, exercise, and other conservative methods fail to provide relief and the pain and immobility increases of the knee joint, your doctor may decide that you now qualify for knee replacement surgery. Knee replacement surgery or knee arthroplasty is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis and also for other knee diseases such as rheumatoid arthritis.
Other major causes of debilitating pain include meniscus tears, cartilage defects, and ligament tears. Debilitating pain from osteoarthritis is much more common in the elderly. Knee replacement surgery can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee.
- WHY KNEE REPLACEMENT SURGERY?
Knee replacement surgery is considered the most optimal pathway to relieve pain once all the conventional methods have failed to provide any relief. If the patient has completed all the prescribed treatments and is still facing acute pain, stiffness, and lack of stability then your doctor would advise you to go for a knee replacement surgery. Doing so will ensure that the patient can experience all previous physical motions pain-free again. According to a market survey, the numbers of joint replacement surgeries in India are increasing every year with the estimates for knee arthroplasty numbers in India to be around 2,00,000 in 2020. Considering the high intensity Asian and Indian lifestyle it is recommended to opt for a high flex knee design. The procedure can help you revive your years of healthy and active living. Hence the impact of Knee Replacement Surgery can be profound.
- DIFFERENT TYPES OF KNEE REPLACEMENT SURGERY
- Total Knee Replacement Surgery (TKR)
This is the most common form of knee replacement surgery. The surgery involves the replacement of both sides of the knee joint. The surgeon replaces the surfaces of the thigh bone and shin bone that connects to the knee. The surgery on average lasts between 1 hour to 3 hours.
- Partial Knee Replacement Surgery (PKR)
Partial Knee Replacement replaces only one side of the knee joint. Lesser of the bone is removed, so the incision is smaller. PKR is suitable for people with damage to only one part of the knee. The hospital stay and recovery period are normally shorter than a Total Knee Replacement surgery. The surgery on average lasts between 45 minutes to 1 hour.
- Revision Replacement Surgery (RRS)
This type of surgery may be needed if the patient has very severe arthritis or if they’ve already had knee replacement surgeries. When a knee replacement no longer functions correctly, revision surgery is often required. During this procedure, the surgeon replaces the old device with a new one. The surgery on average lasts between 2 hours to 3 hours.
The other two types of knee replacement surgeries are
- BENEFITS OF THE KNEE REPLACEMENT SURGERY
There are several benefits of knee replacement surgery, the major ones are as follows:
- Pain Relief
The biggest positive that knee replacement surgery can overcome is to alleviate pain. Knee surgery can remove the debilitating knee pain the patient feels while walking, running, standing, or even when they are sitting or lying down. Knee surgery effectively alleviates pain and helps the patient live an active and healthy lifestyle.
- Better treatment response
Knee surgery may be a good option for people whose chronic knee inflammation and swelling do not get better with rest, medication, or other treatments which include prescribed anti-inflammatory medications, cortisone injections, physical therapy, lubricating injections, or other surgeries. Long-term use of some types of medications, especially opioid pain relievers, can cause complications in the human body. Using such opioid pain relievers for more than a few days can result in physical dependence and severe addiction. Knee surgery reduces your need for medications, physical therapy, and other surgeries and is more sustainable for the long run.
- Improved Mobility
Knee pain is especially disabling because it prevents you from performing most everyday activities. Significant knee pain can sometimes prevent you from even walking short distances inside your own home or at work. Even moderate knee pain can interfere with your ability to take care of yourself and your family. Knee pain can even lead to a sedentary lifestyle, resulting in weight gain and ill health. Knee surgery helps you overcome these problems as your body objectively gets a new joint. Due to advanced innovations in the field of medical devices, new implants are giving better and improved performances enabling people to resume their regular physical activities and live a happy life.
- High success and satisfaction rates
Knee surgery is one of the highly successful surgeries and sees very high patient satisfaction rates. For instance, surgical reconstruction of the ACL has an 82 percent to 95 percent success rate. The successful reconstruction of the PCL is reported in the literature from 75-100% (the average being about 85%). According to the research results presented at the American Association of Orthopaedic Surgeons 2010 Annual Meeting more than 95 percent of patients are satisfied with the results of knee replacement surgery one year after the procedure. Another big benefit of knee replacement surgery is that there are no age restrictions for total knee replacement surgery. Doctors base recommendations for surgery on the patient’s pain and disability, and not the patient’s age. While most patients who undergo total knee replacements are aged 50 to 80, according to the American Association of Orthopaedic Surgeons, knee replacement surgery improves the quality of life for patients of all physical abilities and ages, from teenage athletes to elderly patients.
- WHEN CAN A PATIENT GET BACK TO THEIR EVERYDAY ACTIVITIES AFTER KNEE REPLACEMENT SURGERY?
The surgeon will give the patient-specific instructions about how their condition is. Though it is seen that many people get back to their everyday activities three to six weeks after surgery.
The surgeon and healthcare provider will provide the patient with specific instructions about recovery. The patient will have to gradually increase activity which usually starts with a slow walking program. The patient will be encouraged to stand, climb stairs and perform other normal household activities as soon as possible depending on their condition.
- TYPES OF IMPLANTS
- Golden Knee System, German Make
- Gold surface is used for allergy prevention and wear protection of knee implant
- Hardness superior to Cobalt-Chromium based alloys
- Exceptional durability and absolute Biocompatibility
- Available in PS (Posterior Stabilized) and CR (Cruciate Retaining)
- Total knee system with components made in the UK
- Incorporates an innovative design that redeﬁnes the high-ﬂexion arc of the femur while limiting bone resection along the posterior condyles of the femur.
- Provides surgeons with unique component options that deliver successful, predictable, and reproducible results
- FDA approved cobalt-chromium alloy tibial baseplate is shaped for optimal stability
- Available in PS (Posterior Stabilized) and CR (Cruciate Retaining)
- Also available in an Indian version known as ‘Genuin’
- Indus Knee
- India’s First Posterior Stabilized Hi-Flex Knee
- Offers pain-free mobility with ~128 deg range of motion
- Designed to meet the needs of manually intensive Indian lifestyles, with sizes that suit Indian anatomies
- Posterior stabilized, monoblock design eliminates backside wear
- Genius CR
- HOW LONG DO KNEE IMPLANTS LAST?
Knee replacement was first started in the early 1970s. Back then, surgeons estimated the new knees to last about a decade or so. Today’s implants have better durability and are made from newer advanced technology. On average lasts between 10 and 20 years and in some exceptional cases even more. By the year 2030, it is estimated surgeons will perform about 4,50,000+ total knee replacement operations a year globally.
- UNDERSTANDING YOUR KNEE JOINT
The Knee is the largest joint in the human body and having healthy knees is essential to perform most day-to-day activities.
The knee is primarily made of three bones, the lower end of the thigh bone (femur), the upper end of the shinbone (tibia), and the kneecap (patella). The ends of these three bones are covered with articular cartilage which is a smooth substance that protects the bones and enables them to move easily within the joint.
The menisci are located between the femur and tibia. These C-shaped wedges act as “shock absorbers” that cushion the joint and protect it from injuries.
Large ligaments hold the femur and tibia together and primarily provide stability. The long thigh muscles give the knee strength.
All remaining surfaces of the knee are covered by a thin lining called the synovial membrane. This membrane releases a fluid that lubricates the cartilage, reducing friction to nearly zero in a healthy knee. Normally, all of these components work in harmony. But old age, disease, or a traumatic injury can disrupt this harmony which results in pain, muscle weakness, and reduced function.
- VARIOUS STAGES OF THE KNEE
(LEFT) In this x-ray of a normal knee, the space between the bones indicates healthy cartilage (arrows)
(RIGHT) This x-ray of a knee that has become bowed from arthritis shows severe loss of joint space (arrows)
(LEFT) Severe osteoarthritis
(RIGHT) The arthritic cartilage and underlying bone has been removed and resurfaced with metal implants on the femur and tibia. A plastic spacer has been placed in between the implants.
(Left) An x-ray of a severely arthritic knee.
(Right) The x-ray appearance of a total knee replacement. The plastic spacer inserted between the components does not show up in an x-ray.
- CHOOSE THE BEST!
Choosing a top surgeon to perform complex surgery like knee replacement is as important as choosing the best implants. We at Biorad Medisys design our implants according to the extensive research conducted by the esteemed Indian Institute of Technology, Bombay hence catering specifically to the Indian lifestyle. We care for our patient’s life and hence guide them in choosing the top surgeon around them.
Fill out this form and get access to the top surgeons in your area.
TOP SURGON + BEST IMPLANTS
FASTER RECOVERY & ACTIVE LIFE
- WHAT IS ARTHRITIS?
There are two types of Arthritis – Osteoarthritis and Rheumatoid Arthritis
OA is the most common arthritis and is also called Synovial Arthritis. OA is an old age defect, mostly seen in 50+ people, which is caused by inflammation of the knee cartilage. Eventually, the cartilage breaks and the knee joint bones start rubbing with each other. This results in stiffness, pain, and non-functioning of the joint. Young patients who are diagnosed with OA are usually the ones who have suffered a knee injury or have gotten it due to some pathological reason.
Symptoms of OA
Pain in and around the knee joint, stiffness in the mornings, swelling of the joint, inconsistent pain during nights, a problem during long walks or even in short distance walking, problem in standing for prolonged periods.
Rheumatoid Arthritis (RA)
RA is an autoimmune disease that can cause chronic inflammation of the joints and other areas of the body. It can affect people of all ages. It is a chronic disease characterized by periods of disease flares and remissions. In rheumatoid arthritis, multiple joints are usually, but not always, affected in a symmetrical pattern. Chronic inflammation of rheumatoid arthritis can cause permanent joint destruction and deformity. Damage to joints can occur early and does not always correlate with the severity of RA symptoms.
The ‘rheumatoid factor’ is an antibody that can be found in the blood of 80% of people with rheumatoid arthritis. Early RA treatment results in better outcomes.
Symptoms of RA
RA symptoms and signs include fatigue, joint pain, swollen joints, fever, loss of joint function, as well as joint stiffness, redness, warmth, tenderness, and deformity.
Care at various stages of Arthritis:
The treatment of arthritis optimally involves a combination of the following factors:
One must consult an orthopedic doctor as early as possible once any discomfort or pain in the joint is felt.
Rest and exercise:
Resting allows the body to self-heal. This lowers the need for surgery. Exercising under the guidance of a physiotherapist also helps relieve the pain faster.
People with a heavy built must lose weight as early as possible to reduce pressure on the joint. Weight reduction allows the joint to function smoothly.
Medicines such as Non-steroid-anti-inflammatory-drug (NSAID), immunosuppressants, and steroids are prescribed for pain relief.
In severe cases, surgery is required to provide permanent relief.
- To-Dos – Before you get admitted
Arrange for a caregiver:
After surgery, you’ll need help and care for yourself at home. Plan who will assist you and talk with them about your concerns. If no one is available to care for you, a discharge-planning nurse can help make arrangements for skilled nursing or caregivers to help you at home.
Arrange your meals:
Arranging meals that can be stored and frozen and stocking up on prepared foods will eliminate extra work for your caregiver.
Pack your hospital suitcase:
Pack a small suitcase for your hospital stay that includes a list of your personal hygiene items, comfortable and loose clothing, a knee-length robe, and slip-on shoes. Please leave all of your valuables, including jewelry, wallet, and watches at home. It is not necessary to bring your medications, but please bring a list of your medications and their dosages, as the hospital will provide you with your medications.
- To-Dos – After you get admitted
- Wound Care
The patient will have stitches or staples along the wound or a suture beneath the skin on the front of your knee. The stitches or staples will be removed only after a few weeks after surgery. A suture beneath your skin will not require removal.
The patient will have to care for the wound to prevent any infections. They should avoid soaking the wound in water until it has thoroughly sealed and dried. They may continue to bandage the wound to prevent irritation from clothing or support stockings.
- Food and medications
The doctor or surgeon might advise the patient to stop taking certain medications and dietary supplements before your surgery. The patients are mostly instructed to not eat anything after midnight the day of their surgery. Overall, a balanced diet with more emphasis on iron-rich food is important to help the wound heal and to restore muscle strength.
- Home Care
Several weeks after the surgery, the patient might need to use crutches or a walker. To make your home safer and easier to navigate when recovering, consider doing the following tips:
- Create a living space on one floor since climbing stairs would be difficult.
- Get a stable bench or chair for your shower, only after the surgeon suggests doing it.
- Arrange for a toilet-seat riser with arms if you have a low toilet.
- Remove loose rugs and cords.
- Get a stable chair with a firm seat cushion and back, and a footstool to elevate your leg to give it sufficient rest.
- Install safety bars or a secure handrail in your shower or bath.
- Secure stairway handrails.
- WHAT EXERCISES CAN YOU DO AT HOME POST-SURGERY?
Disciplined exercising after surgery is very important in regaining flexibility and mobility in the knee area. Your surgeon may advise you to perform specific exercises 3-4 times a day and engage in specific walking programs to help you move faster and better. They may suggest some of the exercises below (Please consult your surgeon below performing any of the exercises stated below):
- ANKLE PUMPS
Keep the leg straight on the mat and flex the leg up and down
- KNEE EXTENSIONS
Place a pillow under your knee and lift your leg off the mat
- QUADRICEPS SETS
Keep the leg straight and place a rolled towel under your ankle. Tighten the thigh muscles ajd hold for 5 seconds
- LEG LIFTS
Keep the leg straight on the mat and raise the leg 6 inches above the mat while keeping the knee straight
- WHAT IS THE DIFFERENCE BETWEEN AN ORTHOPEDIC DOCTOR AND AN ORTHOPEDIC SURGEON?
What does an orthopedist do?
An orthopedist will meet with patients and diagnose any issues related to the musculoskeletal system of the body. The patient may struggle with chronic pain from arthritis or a sports injury, an orthopedist or an orthopedic doctor can help diagnose and treat the problem. An orthopedist can provide casts, splints, braces and can reset bones if necessary. They can provide pre-surgery consultation and can actively help with follow-up treatment and recovery after surgery, recommending patients who may seek occupational or physical therapy. An orthopedist guides the patient to an orthopedic surgeon in case surgery is required.
What does an orthopedic surgeon do?
An orthopedic surgeon primarily is responsible for the entire surgical procedure. While orthopedic surgeons will first explore nonsurgical options, they can treat and resolve any musculoskeletal issues which require surgical intervention in the hips, knees, feet, ankles, shoulders, elbows, hands, or the spine. The surgical operations that they perform can help patients suffering from bone tumors, carpal tunnel, arthritis, injuries, back pain, ruptured discs, spinal stenosis, and more. The surgeon will also guide the patient post the surgery in terms of the diet, exercise regime, lifestyle changes that have to be followed.
- WHAT ARE THE ALTERNATIVES TO KNEE REPLACEMENT SURGERY?
The damage severity of the knee determines the alternatives available to knee replacement surgery. It is however said that knee replacement surgery tends to have better long-term results. Some alternatives to knee replacement surgery are as follows:
- Weight Loss and Exercise
- Doctors and surgeons strongly encourage people who are obese or overweight to lose weight and do regular exercise. These measures when practised together can help slow joint damage and reduce pain.
- Research has shown that every extra 10 pounds increase the likelihood of developing knee osteoarthritis by a major 36 percent. On the contrary, losing 10 pounds means you have 4 times less force pressing on your knees.
- Some frequently practised activities include:
- neuromuscular training
- strengthening exercises
- water exercise
- tai chi
- Physical therapy
A professional physical therapist develops a plan to reduce knee pain and strengthen the key important muscles that affect your knees. They can monitor the patients regularly to make sure the exercises are being done correctly.
Acupuncture is an ancient Chinese technique that is said to relieve pain. The method involves the usage of sharp, thin needles which change the flow of energy within the body.
Research shows that acupuncture can help to contain acute knee pain in the short term. Current global guidelines tentatively support the use of acupuncture in treating knee pain but note that its benefits are not proven. The risks of acupuncture are low, so acupuncture may be worth trying.
This alternative is an open operation where the shin bone is cut and re-aligned. After this, the patient does not bear their body weight only on one part of the knee. It may be used for younger patients who have limited arthritis which may postpone a knee replacement.
- MYTHS ABOUT KNEE REPLACEMENT
Myth: Arthritis is just an aging process. You have to learn to live with it.
Fact: Osteoarthritis is a disease of the knee joint which affects millions of people worldwide. It is a chronic condition characterized by the breakdown of joint cartilage which causes rubbing of bones against each other leading to joint pain, stiffness, and loss of movement. There are various ways to alleviate arthritis and no one has to live with it.
Myth: A knee replacement surgery leaves a large noticeable scar.
Fact: With the minimally invasive procedure, there is minimal scarring after knee replacement. The typical scar is 3 – 5 inches long which gradually fades away becoming less noticeable.
Myth: You cannot sit on the floor after knee replacement.
Fact: It depends upon the type of surgery and the patient’s condition. If such activities are to be performed you must discuss them with your surgeon prior to the surgery. Indus Knee Replacement System allows you to live a fairly routine Indian lifestyle.
Myth: It takes months to recover after knee joint replacement.
Fact: With modern techniques and technology available, recovery is quite fast. You would be advised to start taking a few steps the next day of the surgery itself. Most people return to routine activities within a few weeks.
Myth: You should follow the conservative treatment as long as possible even if it means bearing a lot of pain.
Fact: You need not suffer knee pain until it becomes intolerable. Surgery is advised to people even at an early age if they have severe pain which is not relieved much with other conservative treatments.
Myth: Rehab after knee replacement is hard and you cannot expect the full range of motion after knee replacement.
Fact: On the contrary, rehab after surgery is relatively easy. Once the implant is well settled inside your body, it should provide enough range of motion to carry out a routine Indian lifestyle.
Myth: Knee replacements don’t last long.
Fact: Most knee replacements last as long as 10-20 years or more if properly taken care of. Moreover, the quality of life you achieve after a knee replacement is priceless.
Myth: You can consider knee replacement only after 60.
Fact: Not necessarily. If you are living with knee pain that is prohibiting you from carrying out daily activities and you still consider undergoing knee replacement only after 60, is not right thinking. The life of a knee replacement can last as long as 25 years or a lifetime. So you need not wait to turn 60 for a knee replacement.
Myth: Both knees should not be replaced at the same time.
Fact: Both knees can be replaced at the same time if the patient’s health condition is good. In fact, many doctors prefer to do both knee replacements simultaneously if they feel that the patient can tolerate the procedure well. It not only saves money but recovery & rehabilitation is done at the same time, the patient gets back to work and thus saves a lot of financial burden on the patient.
- DOES YOUR HEALTH INSURANCE COVER TOTAL KNEE REPLACEMENT?
Many insurance companies provide coverage for knee replacement surgeries under a standard health insurance policy. People can even purchase a special standalone knee replacement policy in India.
Many people in India are unaware that they can purchase a special standalone insurance policy for knee replacement surgery. This is because, initially, knee replacement was considered a cosmetic procedure, and therefore covered under the regular healthcare plans. With the significant increase in the number of claims filed for knee replacement surgeries over the last decade, many government-run insurance companies started offering a knee replacement insurance policy. Seeing this shift the private insurers followed suit. So, today, you can find various knee replacement surgery insurance policies with different coverage options. Make sure that you compare the plans and choose the one that offers maximum coverage and other benefits.
A few decades ago, the insurance companies often rejected the claim for a knee replacement surgery as the surgery’s definition was not clear and fell in the grey area. However, this has changed recently. Today, many reputed insurers cover the surgery cost under the plan and honor the claim as per the policy’s terms and conditions. However, if you have been holding the same health insurance policy for many years, it would be advisable to contact the insurer and know about the coverage terms before undergoing surgery. Typically, insurers agree to partially (up to 50%) cover the expenses, especially if you hold an old policy.